Gestational diabetes mellitus during pregnancy is a form of diabetes that can pose a threat to the developing fetus. The disease is diagnosed in 3-4% of cases of the total number of pregnancies, the most susceptible to it are pregnant women under 18 and over 30.

Gestational diabetes usually debuts in the second or third trimester and disappears on its own after delivery. In 10-15% of cases, the disease causes a patient to develop type 2 diabetes after giving birth, but even when this does not happen, the increased risk persists for 15 years. In the long-term period, after 10-12 years, type 2 diabetes mellitus develops in 40-60% of women who have had gestational diabetes.

With timely diagnosis and adequate therapy, the prognosis for gestational diabetes mellitus is favorable for both the pregnant woman and the unborn child..

Causes and risk factors Etiopathogenesis of gestational diabetes mellitus during pregnancy is not fully understood. It is assumed that its development is due to blocking the production of a sufficient amount of insulin by hormones responsible for the correct growth and development of the developing fetus.. During pregnancy, hormonal and biological changes occur in the woman's body associated with the formation of the placenta, which secretes chorionic gonadotropin, corticosteroids, estrogens, progesterone, placental lactogen into the mother's bloodstream. These hormones reduce the sensitivity of peripheral tissues to endogenous insulin. The developing violation of the metabolic response to endogenous insulin leads to an increase in lipolysis, while the use of glucose by insulin-sensitive tissues decreases, which, in the presence of risk factors, can cause the development of diabetes.

Autoimmune diseases contribute to the development of gestational diabetes, in which the pancreas is destroyed and, accordingly, the production of insulin decreases. Women whose close relatives have any form of diabetes mellitus doubles the risk of developing gestational diabetes during pregnancy..

Other risk factors include:.

genetic predisposition;

viral infections in early pregnancy;

recurrent candidiasis;

polycystic ovary syndrome;

stillbirth, large fetus, history of polyhydramnios, gestational diabetes mellitus in previous pregnancies;

high blood pressure;

overweight;

bad habits;

physical or mental stress;

unbalanced diet (in particular, eating a large amount of fast-digesting carbohydrates).

In order to prevent the development of gestational diabetes mellitus, it is recommended: rational nutrition, rejection of bad habits, sufficient physical activity.

Forms of the disease Diabetes mellitus in pregnant women is divided into pregestational, in which disorders of carbohydrate metabolism appear in a woman before pregnancy, and gestational, in which the disease first manifests itself during pregnancy.

Gestational diabetes mellitus is subdivided into diet-compensated diabetes and insulin-compensated diabetes combined with diet. Depending on the degree of compensation of pathology, compensated and decompensated gestational diabetes mellitus are distinguished..

Symptoms of gestational diabetes mellitus gestational diabetes mellitus proceeds in waves, its symptoms depend, among other things, on the duration of pregnancy. In some cases, the disease does not have clear clinical manifestations and is detected only during laboratory diagnostics, which is carried out as part of the monitoring of pregnancy.

The main symptom of gestational diabetes mellitus during pregnancy is an increase in the concentration of glucose in the blood of a pregnant woman (usually diagnosed after the 20th week), in the absence of indications of diabetes mellitus in a woman before pregnancy. Other manifestations of gestational diabetes include excessive weight gain, frequent and profuse urination, pruritus, including genital itching, dry mouth, constant thirst, decreased appetite, weakness and fatigue.

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